自凝塑料转移基底冠的临床研究

在上颌前牙的种植义齿修复中,作者利用暂时树脂冠扩张龈缘袖口,指导基桩及烤瓷冠边缘的设计与制作,取得了较好的临床效果。其间,当基底冠被试戴后,由于基桩仍要在口内修复暂时树脂冠,继续扩张龈缘袖口,所以基底冠无法被放回原有模型上,这就需要把基底冠从口内转移到模型上来完成烤瓷。为此,作者探讨了用自凝塑料转移基底冠的方法,取得了较好的临床效果。现报告如下：     

镀金镍铬合金烤瓷冠临床应用

目的：探讨镀金镍铬合金烤瓷冠的优越性能。方法：随机选取门诊病人184例，分为实验组（镀金镍铬合金烤瓷冠）91例和对照组（传统镍铬合金烤瓷冠）93例。烤瓷冠修复后3个月和2年复诊，观察修复成功与否，记录烤瓷冠修复后冠边缘牙龈色泽变化。结果：实验组与对照组在修复成功与否方面无明显差异。镀金镍铬合金烤瓷冠修复颈缘未出现边缘龈着色，镍铬合金烤瓷冠修复颈缘的龈黑线明显。结论：镀金镍铬合金烤瓷冠目前仍是一种比较符合我国国情的修复体。     

前牙金瓷龈边缘和全瓷龈边缘烤瓷修复的美观效果观察

目的　比较前牙烤瓷修复时不同类型的龈边缘与义齿的美观状况。方法　 10 6名前牙要求烤瓷修复患者按不同的龈缘处理方法分为两组 :①唇颊侧金瓷龈边缘 ;②唇颊侧全瓷龈边缘。分别制作前牙烤瓷冠桥 ,戴入后观察 1年以上 ,并参照美国公共健康协会的修正标准 ,评估前牙烤瓷冠桥龈边缘的美观状况。结果　第一组义齿的龈边缘着色分级与第二组存在高度显著性差异 (P <0 .0 0 1) ;其余的分级结果如边缘完整性和继发龋等在两组间无差异。结论　提示唇颊侧纯瓷龈边缘的前牙烤瓷冠桥美观效果更佳。     

金属烤瓷冠对牙龈组织色泽影响临床研究

金属烤瓷冠兼有金属的强度和瓷的美观效果。近年来金属烤瓷冠修复取得了很大的进展 ,是目前较为常用的修复方法。金属烤瓷冠的美观效果不仅在于修复体本身的颜色和形态 ,而且也要注意修复后牙龈组织健康和正常的色泽。随着金属烤瓷冠修复的大量使用 ,因龈缘不美观而影响整体修复效果的临床病例逐渐增多 ,如烤瓷冠粘戴后游离龈变色、唇侧颈缘瓷体不足导致牙龈呈暗青色、非贵金属的颈缘因氧化导致牙龈灰线等 ,降低了患者对修复体的满意度 ,应引起临床医师的足够重视。本文通过对 12 4个牙单位金属烤瓷冠的临床观察 ,对出现牙龈色泽改变的修复…     

烤瓷冠颈缘密合度和位置对牙周健康的影响

目的探讨烤瓷冠颈缘密合度和位置对冠桥基牙牙周组织健康的影响。方法收集已接受烤瓷冠桥修复的患者46例,共63颗基牙,按冠颈缘处是否卡探针分为颈缘密合组和颈缘不密合组,又按冠颈缘位置分为龈上组、齐龈组和龈下组。检查各基牙的菌斑指数、龈沟出血指数及探针深度,并进行统计学分析。结果颈缘不密合组烤瓷冠基牙的龈沟出血指数高于颈缘密合组(P<0.05),龈下组高于龈上组和齐龈组(P<0.05)。结论为了基牙牙周组织健康,烤瓷冠的颈缘应尽可能密合,且边缘不宜做在龈下。     

金属烤瓷冠致牙龈炎的相关因素分析

金属烤瓷冠因其美观、坚固的优势,已经逐渐成为目前较为常见的固定修复方法。修复后牙齿的健康与美观是决定修复成功的重要方面。本文对金属烤瓷冠冠颈部所用材料、冠边缘适合性、龈缘预备形式、冠颈部外形以及操作等方面的因素进行分析,作一综述。     

金属烤瓷冠对龈组织影响的临床分析

金属烤瓷冠的美观效果不仅在于自身的颜色和形态逼真,更在于修复后能获得健康的龈缘组织。作者对72颗前牙金属烤瓷冠修复后,出现龈缘损害而导致龈组织美观受到破坏的病例进行了临床分析。临床资料1997年1月～1999年4月在本院口腔科门诊复诊病人18例,72颗牙均以上前牙金属烤瓷修复后美观效果差为主诉。男6例,女12例。年龄18～36岁。修复原因:切角缺损16颗(22.22%);冠折断24颗(33.33%);四环素牙、氟斑牙18颗(25.00%);龋齿14颗(19.44%)。修复后龈组织损害情况:急性龈炎28颗(38.88%)、慢性龈炎8颗(11.11%)、颈缘间隙20颗(27.22%)、颈缘着色16颗(…     

69例烤瓷冠不同颈缘位置对牙周健康的对比观察

目的：探讨金属烤瓷冠颈缘的不同位置对基牙牙周组织的影响。方法：收集金属烤瓷单冠修复的后牙（包括磨牙和前磨牙）患者50例,69个牙齿,按全冠颈缘位置分为龈上组34例和龈下组35例,修复后1年检查各基牙的牙龈指数,并对发生牙龈炎症的基牙的可能因素进行统计分析。结果：龈下组基牙的牙龈指数高于龈上组（P〈0.05）,龈下组中发生龈炎有20个牙（发病率57%）,是龈上组的10倍（2个牙）。结论：后牙烤瓷全冠修复颈缘位于龈上更有利于基牙的牙周健康。     

含钛镍铬合金、钴铬合金、高金合金烤瓷牙的临床应用比较

[摘要] 目的 比较含钛镍铬合金、钴铬合金、高金合金烤瓷修复体的临床应用效果。方法 选择含钛镍铬合金、钴铬合金和高金合金烤瓷修复患者分别为189例(233单位冠)、206例(251单位冠)和97例(118单位冠)修复完成后分别于3个月、1年、3年复查,检查烤瓷冠的色泽、牙龈炎症、龈缘变色以及裂纹或折裂或崩瓷情况。结果含钛镍铬合金、钴铬合金烤瓷冠在色泽、龈缘炎症(3个月时)、裂纹或折裂或崩瓷方面无显著性差异(P>0.05);龈缘变色(1年及3年时)含钛镍铬合金烤瓷冠高于钴铬合金,并明显高于高金合金烤瓷组(P<0.05);裂纹或折裂或崩瓷,3种材料烤瓷牙相比较,差别无显著性(P>0.05)。结论 高金合金烤瓷冠在化学稳定性、生物相容性、色泽方面具有明显优势;钴铬合金近几年来已逐步取代镍铬合金烤瓷冠;镍铬合金烤瓷冠远期效果有待进一步考证。     

1180颗金属烤瓷冠与牙龈健康关系调查

目的：观察不同烤瓷冠因边缘位置、边缘形态及边缘密合度变化而对牙龈健康的影响。方法：对1180颗金属烤瓷冠在修复后半年至8年进行复查。观察牙龈色泽、牙龈指数及牙周探诊深度的变化。有其中两项检测阳性者表明出现牙龈病变。结果：金属烤瓷冠边缘呈刃状者，边缘位于龈下者，边缘不密合者，牙龈病变发生率都较高。且随时间年限增加而差异有显著性。结论：金属烤瓷冠边缘位置、形态及密合度对牙龈健康具有明显影响。     

Technique for fabricating a cement-retained single-unit implant-supported provisional restoration in the esthetic zone

The fabrication of provisional restorations is an important stage in implant treatment. In the esthetic zone, the potential for error without the use of provisional restorations in the selection of the abutments, framework design, appropriate vertical dimension of occlusion, occlusal profile, and the esthetic interpretation may be significant. Provisional restorations are indicated in esthetic zones, for the contouring of the gingiva, to achieve an acceptable emergence profile, to have custom-guided tissue healing, and to induce appropriate soft-tissue topography. This article describes the fabrication of a provisional restoration for a single-unit implant-supported crown.     

The comparison of provisional luting agents and abutment surface roughness on the retention of provisional implant-supported crowns

STATEMENT OF PROBLEM: In immediate implant loading, it is important to keep provisional restorations in place during early-phase healing. Current luting agents for provisional restorations may provide inadequate retention, creating a clinical challenge. PURPOSE: This study compared the retention of provisional autopolymerizing acrylic resin implant-supported single restorations with combinations of different implant abutment surface conditions and provisional luting agents. MATERIAL AND METHODS: Thirty solid titanium implant abutments (ITI), 4 mm high, were divided into 3 groups. Ten abutments were unaltered, 10 were airborne-particle abraded with 50-microm aluminum oxide, and 10 were roughened with a medium-roughness diamond rotary cutting instrument. Thirty implant analogs (ITI) were mounted in autopolymerizing acrylic resin blocks. A solid titanium implant abutment was placed in each implant analog and torqued to 35 N.cm. After fabrication of 4 provisional acrylic resin crowns for each abutment, provisional luting agents TempBond, TempBond NE, Life, and Zone were used to secure the provisional crowns to the respective abutments. All specimens were luted with one of the provisional luting agents for a given test. After ultrasonic cleaning of the abutments, another provisional crown was luted with another luting agent. All specimens were stored in 100% humidity environment for 1 day at 37 degrees C prior to testing. Each provisional acrylic resin crown was pulled from the abutment with a 500-kg load cell in a universal testing machine at a crosshead speed of 0.5 cm/minute, and tensile strength was recorded (N). Data were analyzed using analysis of variance (ANOVA) and the Scheffe test (alpha=.05). RESULTS: Tensile strength was significantly higher for Life and TempBond NE than for TempBond and Zone, regardless of the surface conditions (P=.0001). The result of the 2-way ANOVA indicated that a significant interaction existed between the provisional luting agents and surface conditions (P=.0039). TempBond NE showed significantly higher tensile strength when combined with airborne-particle-abraded surfaces compared to other combinations (P=.011). However, no difference was found in tensile strength of Life and Zone between different combinations. The tensile strength of TempBond was lower when used with the unaltered surface compared to other combinations (P=.001). CONCLUSION: Surface modification of an implant abutment by airborne-particle abrasion or diamond rotary cutting instrument did not improve retention of a provisional acrylic crown when Life or Zone was used as the luting agent. Airborne-particle abrasion may be an effective method to increase retention of a provisional acrylic crown when TempBond NE is used.     

Interim esthetic restorations in conjunction with anterior implants.

This article describes 2 procedures that can be used to provide acceptable anterior esthetics from the time of extraction, through implant placement and uncovering, until the completed implant-supported and retained crown is inserted. The first procedure presents a simple treatment option to prevent esthetic embarrassment immediately after implant placement. The second procedure uses a claspless, acrylic resin temporary removable partial denture to overcome many of the esthetic problems attendant with immediate replacement.     

Fabrication of a screw-retained fixed provisional prosthesis supported by dental implants

Screw-retained provisional implant-supported prostheses may have advantages over cement-retained prostheses in certain situations. This article describes a technique for fabrication of screw-retained provisional acrylic resin implant-supported prostheses from the modified metal components provided with the implant.     

Fabrication of a New Crown and Provisional to an Existing Removable Partial Denture

A method of fabricating a new crown to an existing removable partial denture is described. A press-form plastic shell made from the diagnostic cast provides the outer contours for the abutment tooth, while an acrylic resin coping is fabricated on a die to provide accurate internal adaptation. The acrylic resin coping is seated on the prepared abutment. Autopolymerizing acrylic resin is mixed and placed in the plastic shell that is then placed in the mouth over the coping, forming the acrylic resin crown pattern. The removable partial prosthesis is fitted over the crown pattern intraorally. The pattern is transferred back to the die, the margins are refined, and the casting is completed and finished, avoiding reduction of the established contours. The same plastic shell is used with tooth-shaded acrylic resin to construct a provisional crown directly in the mouth. This technique allows the patient to wear the removable partial denture while the laboratory procedures are completed.     

Immediate provisional restoration of an implant placed in a fresh primary maxillary canine extraction socket: a case report

This study describes a clinical case in which a primary maxillary canine with both mobility and root resorption was replaced with an immediately restored dental implant placed into the fresh extraction socket. The implant achieved high primary stability, as determined by resonance frequency analysis, and it was immediately restored with a provisional acrylic resin crown with no centric occlusion. An all-ceramic permanent crown replaced the provisonal crown four months after implant surgery. The implant was stable and no periapical radiolucencies, bleeding on probing, or pathologic probing depth were recorded after one year. The peri-implant soft tissue level appeared stable, and the interdental papillae were preserved, contributing to an optimum final esthetic result. This case supports the use of single implants for the replacement of extracted primary teeth, especially in areas where esthetics is a high priority. The immediate provisional crown maintained soft tissue contours and papillary height.     

Esthetic potential of single-implant provisional restorations: selection criteria of available alternatives

Provisional implant restorations are essential tools used to optimize the esthetic outcomes for single-tooth implant restorations. This article describes three groups of available alternatives and the specific options within each group including removable prostheses (interim removable partial denture, vacuum-formed appliance), tooth-supported prostheses (bonded extracted or denture teeth, cast metal or fiber-reinforced resin-bonded fixed partial denture [FPD], wire-retained resin-bonded FPD, acrylic resin provisional FPD), and implant-supported fixed prostheses (implant-retained provisional restoration). Advantages and disadvantages as well as fabrication guidelines for each option are provided. The author proposes that the restorative dentist consider eight criteria in selecting the most appropriate type of provisional prosthesis for a specific patient situation including the esthetic potential, patient comfort, treatment time, laboratory cost, occlusal clearance, ease of removal, durability, and ease of modification. The patient's esthetic expectations are critical in determining the most suitable type of provisional restoration. Esthetically pleasing provisional restorations are part of the evolving implant continuum, making implant dentistry more appealing to practicing dentists and potential patients. CLINICAL SIGNIFICANCE: Provisional restorations for single implants have evolved from temporary expedients during osseous and soft tissue integration to critical therapeutic tools used to assess patient expectations, communicate with the laboratory, and optimize definitive implant treatment. The selection of the type of provisional restoration may significantly influence esthetics during the period of implant integration and soft tissue healing. However, it is unlikely that there is a direct correlation between the type of provisional restoration used and the esthetic outcome of the definitive prosthesis.     

Use of a customized rigid clear matrix for fabricating provisional veneers.

The fabrication of provisional veneers is time consuming, and may be unpredictable, especially in cases of multiple veneer preparations; however, functional and esthetic provisional veneers, may be used as diagnostic adjuncts for the fabrication of the definitive restoration. This article presents, in a step-by-step procedure, the use of a customized rigid clear matrix with light-cured composite resin as a fast alternative for the fabrication of functional and esthetic provisional composite resin veneers. CLINICAL SIGNIFICANCE: The use of a customized rigid clear matrix for the fabrication of light-cured composite resin provisional veneers has the following advantages: the shape and surface texture produced in the diagnostic wax-up are accurately transferred to the patient's mouth; the provisional restoration is fabricated without violation of the soft tissue and the margins of the preparations; use of the matrix can be repeated when needed; and esthetic and functional provisional veneers can be fabricated relatively quickly.     

Esthetic rehabilitation of anterior discolored teeth with lithium disilicate all-ceramic restorations

The esthetic treatment of darkened anterior teeth represents a great challenge to dentists, because dental materials ideally should match the natural teeth. The optical behavior of the final restoration is determined by the color of the underlying tooth structure, the color of the luting agent, and the thickness and opacity of the ceramic material used. This article reports a case in which veneers and full crowns made of heat-pressed, lithium disilicate glass-ceramic were used for the esthetic rehabilitation of anterior discolored teeth. The patient was referred for treatment with defective anterior composite resin restorations, provisional acrylic resin crowns, darkening of the gingival margins, and uneven gingival contours. The multidisciplinary treatment plan included dental bleaching, periodontal plastic surgery to create gingival symmetry, and indirect all-ceramic restorations using high-opacity lithium disilicate glass-ceramic ingots. The treatment was successful and an excellent esthetic result was achieved.     

A provisional and new crown to fit into a clasp of an existing removable partial denture

A technique that forms an abutment crown to fit into an existing clasp of a removable partial denture by relining an acrylic resin pattern is described. The outer contour of the pattern is made within an irreversible hydrocolloid impression by use of Duralay autopolymerizing acrylic resin applied with precision dispensers. The pattern is formed before tooth preparation and is made approximately 0.4 mm thick. After tooth preparation, the shell pattern is relined with the same autopolymerizing resin and the existing removable partial denture is fitted over it. The gross pattern is trimmed and the margins refined on a die made from an elastomer impression. The refined pattern is cast and finished, avoiding reduction of the contours established. A second crown is similarly formed in tooth-colored autopolymerizing acrylic resin. It serves as a provisional restoration that allows the patient to wear the removable partial denture while the laboratory procedures are performed.